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General NPI Number Information
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NPI Number | 1699427435
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Entity Type | Organization
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Legal Business Name | NEW LEAF FAMILY COUNSELING, PLLC
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Dates
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Enumeration Date | 01/24/2022
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Last Update Date | 07/01/2024
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Provider Practice Location Address
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Address Line | 220 W CONGRESS ST
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City | DETROIT
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State | MI
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Zip | 48226-3289
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Country | US
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Telephone | 313-207-1813
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Fax |
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Provider Business Mailing Address
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Address Line | 777 PATRICIA PLACE DR
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City | WESTLAND
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State | MI
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Zip | 48185-3895
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL THERAPIST
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Name | NIKKIA DANIELLE MATTHEWS
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Credential | LMSW
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Telephone | 734-502-0503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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